Preview — No Apparent Distress
by Rachel Pearson

No Apparent Distress: A Doctor's Coming-of-Age on the Front Lines of American Medicine

In medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.

Rachel Pearson confronted these harsh realities when she started medical school inIn medical charts, the term “N.A.D.” (No Apparent Distress) is used for patients who appear stable. The phrase also aptly describes America’s medical system when it comes to treating the underprivileged. Medical students learn on the bodies of the poor—and the poor suffer from their mistakes.

Rachel Pearson confronted these harsh realities when she started medical school in Galveston, Texas. Pearson, herself from a working-class background, remains haunted by the suicide of a close friend, experiences firsthand the heartbreak of her own errors in a patient’s care, and witnesses the ruinous effects of a hurricane on a Texas town’s medical system. In a free clinic where the motto is “All Are Welcome Here,” she learns how to practice medicine with love and tenacity amidst the raging injustices of a system that favors the rich and the white.

No Apparent Distress is at once an indictment of American health care and a deeply moving tale of one doctor’s coming-of-age....more

Community Reviews

No Apparent Distress: A Doctor's Coming of Age on the Front Lines of American Medicine by Rachel Pearson, MD is a 2017 W.W. Norton Company publication.

This book is an eye-opening shocker told from the personal experience of Rachel Pearson a young woman who enters the medical profession and trains in various public hospitals and small town clinics, learning the hard way that despite her compassion and will to care for patients, the poor and uninsured face more challenges in getting the care theyNo Apparent Distress: A Doctor's Coming of Age on the Front Lines of American Medicine by Rachel Pearson, MD is a 2017 W.W. Norton Company publication.

This book is an eye-opening shocker told from the personal experience of Rachel Pearson a young woman who enters the medical profession and trains in various public hospitals and small town clinics, learning the hard way that despite her compassion and will to care for patients, the poor and uninsured face more challenges in getting the care they need, due to an incredibly flawed system.

Rachel relates to the reader the many ways mistakes can be made, unnecessarily putting patients at risk, the bias that can affect treatment options, and the limited resources available to patients who are uninsured.

But, we also watch Rachel's struggle with the inclination to offer basic human compassion and the way she was being taught to keep her emotions in check and remain professional. These cases are difficult to read about, but exposes the system's flaws, in a way many people just can't understand or don't want to admit to. The fact that Rachel experienced this first hand, and is a doctor, not a politician, or pharmaceutical salesperson, or insurance agent, but someone who has been there on the front lines, so to speak, should convince anyone who may be skeptical that this is a stark reality in our country. It's shameful to be frank. But, I will say, that as someone who has seen even the most priviledged, affluent, and well insured patients herded through hospitals like cattle, with little or no bedside manner to be seen, or with doctors literally rolling their eyes at patients who ask questions or express concerns about their treatment, Rachel's struggle with her initial innocence and idealism which contrasted sharply with the reality of her situation, proved that there really are doctors out there who care about their patients, whether they are insured or not. I highly recommend this book for no other reason than to educate yourself about how the poor are basically used as training specimens, the many disadvantages they have compared to those have insurance, and the heartless blind eye that is turned on this ugly, hidden truth.

Rachel also reminded my cynical self that doctors are human beings too, and helped me see a different side of the equation. Some of these cases still haunt Rachel, but I hope she will focus on the good things she will do for her patients now, and that she did learn something from this experience.

On a more positive note- While this book highlights an area of healthcare that many are unaware of unless they are in the trenches, there are many heroes in the health care business who perform miracles every day. This book merely draws attention to some of the issues we need to work on, especially in public hospitals.

When Rachel Pearson was a medical student at the University of Texas Medical Branch in Galveston, she was given the opportunity to work at the St. Vincent community clinic. Medical students who volunteered there were able to acquire “hands on” experience while working with poor, uninsured patients who were primarily minorities, as well as with prisoners in the nearby correctional facility.

In this revealing memoir, Dr. Pearson sheds light on the injustices imbedded in the American health care syWhen Rachel Pearson was a medical student at the University of Texas Medical Branch in Galveston, she was given the opportunity to work at the St. Vincent community clinic. Medical students who volunteered there were able to acquire “hands on” experience while working with poor, uninsured patients who were primarily minorities, as well as with prisoners in the nearby correctional facility.

In this revealing memoir, Dr. Pearson sheds light on the injustices imbedded in the American health care system which provides better treatment to patients who are white and insured. Medical students gained skills and learned more about the practice of medicine while working with the underprivileged patients. Mistakes were made unintentionally at the patients’ expense. But lessons were learned.

Dr. Pearson’s honest and heartfelt account focuses on the training of new doctors and the problems that exist in the health care system currently in place in the United States. ...more

I’d recommend this clear-eyed insider’s glimpse into American health care to readers of Lab Girl and surgeon Henry Marsh. Like Hope Jahren’s memoir, it’s a detailed and earnest story of finding a scientific vocation; like Marsh’s books, it has something of a confessional tone. Rachel Pearson is keenly aware of her failings as a trainee doctor and expresses regret about the patients she didn’t save due to her greenness. She opens and closes with the story of Mr. Rose; she missed a tumor the sizI’d recommend this clear-eyed insider’s glimpse into American health care to readers of Lab Girl and surgeon Henry Marsh. Like Hope Jahren’s memoir, it’s a detailed and earnest story of finding a scientific vocation; like Marsh’s books, it has something of a confessional tone. Rachel Pearson is keenly aware of her failings as a trainee doctor and expresses regret about the patients she didn’t save due to her greenness. She opens and closes with the story of Mr. Rose; she missed a tumor the size of two grapefruits in his belly because both of them were such “poor historians.”

From here she retreats to tell of her Texas upbringing and the many different hands-on stages involved in her medical training: a prison hospital, gynecology, general surgery, rural family medicine, neurology, dermatology. Each comes with its own memorable stories, but it’s her experiences at St. Vincent’s Student-Run Free Clinic on Galveston Island that stand out the most. Many of their patients were minorities; some were ex-cons, and those who weren’t homeless were most likely living under the poverty line.

Pearson speaks out clearly about the divide between rich and poor Americans (often mirrored by the racial gap) in terms of what medical care they can get. In many cases people are dying simply because they cannot afford the best care. (She doesn’t really talk about whether the Affordable Care Act has made any difference; this is something I wish she’d covered.) For instance, her patient Vanessa’s husband died quickly because they were uninsured and weren’t offered the special CT scan that could have caught his lunger cancer in time. Contrast that with the posh general practice clinic where she did a placement, the kind of place that hosts evening “Botox parties.”

“We become physicians when we are honest about our mistakes, and start listening a little harder,” Pearson writes, and this book is the proof that she’s kept her eyes and ears open to what ordinary people are going through – and her heart open to what she’s done wrong and what she can do better....more

as someone who's spent four years working with mentally ill homeless people, i relate strongly to the feeling that, to paraphrase the author, your life becomes unspeakable. the vast majority of the world can't handle these stories, but you need to let them out somewhere. where do they go? rachel pearson turned hers into art. mostly pitch-perfect little keyhole-glimpses into a world that is impossible to explain, to define, to really convey the true meaning. it's difficult to put down, mesmerizinas someone who's spent four years working with mentally ill homeless people, i relate strongly to the feeling that, to paraphrase the author, your life becomes unspeakable. the vast majority of the world can't handle these stories, but you need to let them out somewhere. where do they go? rachel pearson turned hers into art. mostly pitch-perfect little keyhole-glimpses into a world that is impossible to explain, to define, to really convey the true meaning. it's difficult to put down, mesmerizing, heartbreaking and inspiring. and, to be honest, a 4-star book, but i gave it 5 stars to counteract that one-star dumbass who clearly didn't read closely and just let her own shitty politics get in the way. ...more

Pearson has written about her fairly recent medical training in south Texas in a sort of hybrid memoir/social justice issues piece. She includes a few representative details about her childhood. The daughter of hardworking, poor, and, for some time uninsured parents, she—and her brother—were much loved and very clever. Originally planning to pursue a career as a writer, she realized through discussion with her dad that she preferred practical work, whose impact could be seen and felt. Medicine jPearson has written about her fairly recent medical training in south Texas in a sort of hybrid memoir/social justice issues piece. She includes a few representative details about her childhood. The daughter of hardworking, poor, and, for some time uninsured parents, she—and her brother—were much loved and very clever. Originally planning to pursue a career as a writer, she realized through discussion with her dad that she preferred practical work, whose impact could be seen and felt. Medicine just made sense.

Pearson spends a good deal of time documenting the errors she made as a doctor trainee. For the most part, students at her medical school learned on the indigent and disadvantaged. Pearson appears to have had few encounters with the middle class. One insured patient she meets during her internal medicine rotation refuses to be seen by her—a student. The contrast in the agency and entitlement of financially comfortable patients and poor ones is stark and telling.

Pearson’s patients don’t really come alive on the page. Indeed, the author appears to be more preoccupied with addressing (and possibly atoning for) her diagnostic and treatment errors—through writing about those mistakes—than she is about the patients themselves. On the whole, her book is an informative read that addresses many issues—not just the disparity in care between the insured and uninsured, but also the inferior medical care received by Latinos, Blacks, and prisoners....more

If you are deeply concerned about the plight of the poor in America—and, in particular, the roadblocks they face in getting even the smallest health care need met—then this is going to be an extremely difficult book for you to read.

As I write this review,the date is currently January 23, 2017. Three days ago, Donald Trump was inaugurated as the 45th President of the United States of America. The House of Representatives and the Senate is in Republican control and it’s just a matter of time beforIf you are deeply concerned about the plight of the poor in America—and, in particular, the roadblocks they face in getting even the smallest health care need met—then this is going to be an extremely difficult book for you to read.

As I write this review,the date is currently January 23, 2017. Three days ago, Donald Trump was inaugurated as the 45th President of the United States of America. The House of Representatives and the Senate is in Republican control and it’s just a matter of time before a new Supreme Court Justice is appointed—who will most certainly be a Conservative—which means all three branches of the Federal government will be under Republican control. By the time this review is published in late April, it is very likely that under this Republican majority, the Affordable Care Act will have been repealed, which will be particularly devastating to the most vulnerable in our society who gained coverage through the medicaid expansion (if they were fortunate enough to live in a state that expanded medicaid).

Which makes this a most timely read, indeed.

No Apparent Distress recounts the author’s days as a medical student in Galveston, Texas, detailing some of her experiences working in St. Vincent’s Student-Run Free Clinic. Staffed by volunteer students and physicians from University of Texas Medical Branch, St. Vincent’s offered health services for the uninsured poor. Financial limitations restricted the care patients received, sometimes with deadly results.

Pearson doesn’t shy away from admitting her own mistakes and shortcomings as a medical student; she shares those stories with regret and the 20/20 hindsight that wisdom brings. Nor does she hide her frustration about the disparity of care available to the insured vs. the uninsured, given examples of the inequalities she noticed while working/learning at the office of another doctor whose patients were insured and had considerable financial means, as well.

The Haves… and the Have-Nots.

If ever there was a book that inspired compassion for those less fortunate, it’s this one. If you’re seeking understanding about what it’s like to be poor and uninsured in America, I urge you to read this book. It’s definitely an eye-opener.

I received an advance review copy of this book courtesy of Netgalley and W. W. Norton & Company....more

This is a pretty good book but it had some problems that made it very tedious at times. Her editor should have told her that if a character in your book appears for a short finite time you do not need to give their entire life history and your reader most definitely does not want to read that. Going with your brother on a commercial fishing trip is interesting; a detailed description of how the boat and commercial fishing works is not, at least not in a medical memoir. This is more a memoir thanThis is a pretty good book but it had some problems that made it very tedious at times. Her editor should have told her that if a character in your book appears for a short finite time you do not need to give their entire life history and your reader most definitely does not want to read that. Going with your brother on a commercial fishing trip is interesting; a detailed description of how the boat and commercial fishing works is not, at least not in a medical memoir. This is more a memoir than a book about social injustice in medicine. I think we've all figured out that if you're poor and sick in Texas you're pretty much out of luck but even so the best parts of this book were the stories of truly heroic doctors and medical students struggling to help people in very dire straits, very often to no avail....more

I liked reading about a doctor and her journey through school and life and with her patients. I know I sometimes forget that doctors are humans with emotions. This is a good book for viewing doctors as humans who feel and do care about their patients.

This book shows in no uncertain terms the inequities of our current health system. I knew there were major problems, but never had read about people who are diagnosed with, for example, cancer and who can't get any medical help for it. They are literally turned away from all the hospitals and assistance programs in a pretty wide area. I thought there was more of a safety net than there actually is. At least, there's hardly any safety net in Texas, and those who are poor and nonwhite fall throughThis book shows in no uncertain terms the inequities of our current health system. I knew there were major problems, but never had read about people who are diagnosed with, for example, cancer and who can't get any medical help for it. They are literally turned away from all the hospitals and assistance programs in a pretty wide area. I thought there was more of a safety net than there actually is. At least, there's hardly any safety net in Texas, and those who are poor and nonwhite fall through it most. Barbaric and disgusting.

However, the book didn't seem to know exactly what it wanted to be. Personal and family memoir, journalistic expose, human interest journalism, and stories of being a medical student were all jumbled together. Most of it was interesting, but it seemed a bit disjointed do me....more

It boggles the mind that someone who wants to save lives begins her book with stories of abortions. She chose stories that may, to her, have shown compassion for a woman but, in reality, displayed a total lack of empathy and concern for the woman and especially for the babies. How can you go through so much expense and study and work to save others and yet so casually destroy human life and present it as a good? Women deserve better than this.

It can be difficult for a patient to understand just how much a physician must experience in order to be called "Doctor". Dr. Pearson takes us on her quest through the trials and tribulations on her way to taking the hippocratic oath. Hippocrates surely had less philosophy to master than the modern day practitioner.

Whether its dying patients or turning away the cancer-diagnosed for lack of funding, Pearson elucidates the struggle to achieve care for the sick even in the age of the Affordable CaIt can be difficult for a patient to understand just how much a physician must experience in order to be called "Doctor". Dr. Pearson takes us on her quest through the trials and tribulations on her way to taking the hippocratic oath. Hippocrates surely had less philosophy to master than the modern day practitioner.

Whether its dying patients or turning away the cancer-diagnosed for lack of funding, Pearson elucidates the struggle to achieve care for the sick even in the age of the Affordable Care Act. Can a truly enlightened society be one where the sick can be diagnosed but not cured?

The author of this book spends a great deal of time explaining the quandaries of low-income health care and the lack thereof. From one heart-breaking story to the next the reader has thrust into full view the process of becoming a doctor and the process of attempting to get care to those who "Do not qualify".

The writing is far better than one might expect from a physician. This is a story, or more a series of them, and not a clinical diagnosis. One might expect a book of scientific and medical jargon. This book contains neither.

If you have interest in becoming a medical student, how a student becomes a physician, and particularly well-told stories about these endeavors, I recommend "No Apparent Distress".

Disclaimer: This advance review copy was provided by the fine publisher WW Norton free of charge for the purpose of review. The public-release copy may vary from the copy that was the subject of this review.

Further Disclaimer: Any publisher that sends me a quality book free of charge for review will be referred to as a "fine publisher"....more

Is health care a "human right"? If so, what does that mean in practice?

In my profession in the social work field in a hospital, I see many of the injustices that Pearson writes about on a day-to-day basis. Luckily, the state I live in has expanded Medicaid to help many more people, so it's not quite as desperate as she describes. However, I appreciated her insight into the other ways that medicine treats the poor badly - through experimentation and practice, to name a few - as well as how her prIs health care a "human right"? If so, what does that mean in practice?

In my profession in the social work field in a hospital, I see many of the injustices that Pearson writes about on a day-to-day basis. Luckily, the state I live in has expanded Medicaid to help many more people, so it's not quite as desperate as she describes. However, I appreciated her insight into the other ways that medicine treats the poor badly - through experimentation and practice, to name a few - as well as how her practice has shaped her as a physician and a human being.

There was likely a lot more history she could have brought in, and more calls to action to deepen the story, but overall a clear enough picture of what we face in this country in our medical system. If you are reading about the proposed changes to the ACA and wondering what's the big deal, read this book. I'd also recommend it to new or aspiring doctors and social workers entering the medical field....more

pretty good writer... engrossing read. the whole premise was about the disillusionment of the free-medical care system and bureaucracies and such but she then closes with how without those experiences it wouldn't have made her the would-be doctor and human she is today... it was like she had to write a paper or this novel was a dissertation of some sorts where she had to put some positive acknowledgements of the system so she doesn't get ostracized by the medical community. Which totally put a dpretty good writer... engrossing read. the whole premise was about the disillusionment of the free-medical care system and bureaucracies and such but she then closes with how without those experiences it wouldn't have made her the would-be doctor and human she is today... it was like she had to write a paper or this novel was a dissertation of some sorts where she had to put some positive acknowledgements of the system so she doesn't get ostracized by the medical community. Which totally put a damper on the book cuz basically that whole stage in life was just that? a stage? Did she take those experiences and bring it forward in a practical manner to something in which she can better? or was she just lamenting the system being too big to fight?...more

Rachel Pearson's memoir of going through medical training in Galveston, Texas.Reading the back cover was unnerving where she says that medical students learnon the bodies of the poor, and the poor suffer from their mistakes. **gulp**Some of her training took place in a clinic for the uninsured. They didn't have accessto the same tests, procedures, surgeries, that people received when they had insurance.So unfair. But it all comes down to money. The health system favors the rich and thewhite patiRachel Pearson's memoir of going through medical training in Galveston, Texas.Reading the back cover was unnerving where she says that medical students learnon the bodies of the poor, and the poor suffer from their mistakes. **gulp**Some of her training took place in a clinic for the uninsured. They didn't have accessto the same tests, procedures, surgeries, that people received when they had insurance.So unfair. But it all comes down to money. The health system favors the rich and thewhite patients.Pearson has an easy to read style of writing. You will learn a lot that you likely didn'tknow before. It's also entertaining.THANK YOU so much--I received this book from the Goodreads Giveaway. Muchappreciated!...more

Every one of the 217 would-be killers in the House of Representatives who voted for the AHCA last week should be forced to read this book, and/or spend a day in their local safety net hospital assisting people to apply for Charity Care.

Real stories from a real doctor who worked in rural Texas during medical school.

A very timely telling of the terrors of today's medical opportunities to the less privileged. Through her schooling and clinic volunteering, Pearson experiences the heartbreak of having to let people suffer due to not having the right insurance to get them the needed care. Doing all she (and her comrades) can to help those in need, it leaves an abyss of what can actually be done. I was surprised that she admitted to a number of medical errors she made in her training, but applauded her franknessA very timely telling of the terrors of today's medical opportunities to the less privileged. Through her schooling and clinic volunteering, Pearson experiences the heartbreak of having to let people suffer due to not having the right insurance to get them the needed care. Doing all she (and her comrades) can to help those in need, it leaves an abyss of what can actually be done. I was surprised that she admitted to a number of medical errors she made in her training, but applauded her frankness. This book was a real education for me, as I really had no idea just how bad it is out there for the uninsured or even under-insured. I guess the Hippocratic Oath is as passe as looking up from your cell phone to say "Hello."

This book was EXCELLENT. Rachel is the kind of doctor I would want treating my parents. I appreciated her candor as she highlighted the rigors of med school and the things she wished she’d done differently. I’m not a physician but I have patients who have stuck with me since my pharmacy training. Patients who made an impact on me and influence my practice to this day. This book is a memoir of Rachel’s medical school experience but it’s also an example of the way our medical system fails people oThis book was EXCELLENT. Rachel is the kind of doctor I would want treating my parents. I appreciated her candor as she highlighted the rigors of med school and the things she wished she’d done differently. I’m not a physician but I have patients who have stuck with me since my pharmacy training. Patients who made an impact on me and influence my practice to this day. This book is a memoir of Rachel’s medical school experience but it’s also an example of the way our medical system fails people of color, the poor, and undocumented. ...more

This book has many layers of meaning that explored the lesser known areas in the high profile subject matter, that is medicine, which most people claim to know a great deal about. “No Apparent Distress” is such a substantive title. It’s true that the best way to go about empathising with others is to experience what others have experienced, but the fact of life is we can’t live out ten thousand different lives just so we can empathise with the many people we encounter. But we can hear out theirThis book has many layers of meaning that explored the lesser known areas in the high profile subject matter, that is medicine, which most people claim to know a great deal about. “No Apparent Distress” is such a substantive title. It’s true that the best way to go about empathising with others is to experience what others have experienced, but the fact of life is we can’t live out ten thousand different lives just so we can empathise with the many people we encounter. But we can hear out their stories and listen. Sometimes just being there is enough. ...more

This is a fascinating look at the evolution of a doctor. It's also a pretty insightful insider's look at health care for the indigent and working poor in Texas. Finally, I found the author's philosophies about working in medicine and helpful for me as a librarian. I often also deal with ill and/or indigent patrons, and I want to provide the best service I can, while still not burning out. So I tried to consider some of her ideas for myself.

his is a great story of one womans quest to give care to her patients. its also a good outline of how many people pur system fails due to its need for money over people. hopefully one day we can get care for everyone regardless of socio-economic status.

I enjoy journalistic medical account and this was a great combo by an actual doctor. sometimes doctors writing can be very dry or clinical but this infused emotion and was able to get some great info out.

I wish everyone could gain the insights on the US healthcare mess that the author relates in this account of her medical training experiences. While the stories themselves are quite interesting, I could picture them well since they are mostly set in the Galveston area and the impact of recent hurricanes is discussed.

There is even less of a safety net for the uninsured than I imagined. It will make you think about medical ethics and humane treatment.

Admirable storytelling and honesty about her oI wish everyone could gain the insights on the US healthcare mess that the author relates in this account of her medical training experiences. While the stories themselves are quite interesting, I could picture them well since they are mostly set in the Galveston area and the impact of recent hurricanes is discussed.

There is even less of a safety net for the uninsured than I imagined. It will make you think about medical ethics and humane treatment.

Admirable storytelling and honesty about her own regrets makes this an enjoyable, if sometimes depressing, book. ...more

This book was beautifully written and kept me turning the pages way past my bedtime. The author was vulnerable without being overly confessional. The book was in a lot of ways just as political as it was personal, without ever hitting you over the head with its message. That said, I wish everyone who feels healthcare is a privilege, not a basic human right, would read this book.

Dr Pearson honestly describes her journey, successes, and failures through medical school challenges and the healthcare system itself. She touches on the struggle individuals face determining their roles, balancing personal issues with rigorous studies as a student and later balancing their humanity with the cold realities of medical possibilities and financial restrictions. It is a timely look at the inequalities of our healthcare system (I can imagine an author's note in the paperback releaseDr Pearson honestly describes her journey, successes, and failures through medical school challenges and the healthcare system itself. She touches on the struggle individuals face determining their roles, balancing personal issues with rigorous studies as a student and later balancing their humanity with the cold realities of medical possibilities and financial restrictions. It is a timely look at the inequalities of our healthcare system (I can imagine an author's note in the paperback release updating us on how St Vincent's weathered the current changes in affordable care). I was reminded of "The Immortal Life of Henrietta Lacks", how the poor don't get the care they need or credit they deserve for their contributions and suffering. In disclosure, I received an advance copy as a good reads winner....more

loved this book. having worked in the medical field for a number of years, I have used the phrase used for the title of this book. in charting I would sum up the condition of a patient sometimes in these words. liked her story of having to work hard to get into the medical field. having worked in the abortion clinic and other places would broaden a student's outlook while working as a doctor. do not know if I completely agree that the poor peoplereceived advance reading copy to read and review.

loved this book. having worked in the medical field for a number of years, I have used the phrase used for the title of this book. in charting I would sum up the condition of a patient sometimes in these words. liked her story of having to work hard to get into the medical field. having worked in the abortion clinic and other places would broaden a student's outlook while working as a doctor. do not know if I completely agree that the poor people gets the basic treatment while those with more money receive better treatment. I think most medical staffers only see a basic person in need of their skill and training. will pass this book onto my daughter who teaches a health career pathway class in high school. feel her students would enjoy this book....more

Well written, compelling nonfiction about a doctor choosing to go to medical school in Galveston, Texas a year after Galveston was devastated by flooding in 2008. Pearson focuses mostly on her time volunteering as a student at a free clinic: St. Vincent's. While the university's hospital used to focus on care for people who could not afford it, they stopped providing this in large part in the years leading up to and after the flood, so many of the people who go to St. Vincent's cannot follow upWell written, compelling nonfiction about a doctor choosing to go to medical school in Galveston, Texas a year after Galveston was devastated by flooding in 2008. Pearson focuses mostly on her time volunteering as a student at a free clinic: St. Vincent's. While the university's hospital used to focus on care for people who could not afford it, they stopped providing this in large part in the years leading up to and after the flood, so many of the people who go to St. Vincent's cannot follow up with the care they need at the hospital. I especially appreciated that Pearson looks at how race and socioeconomic status affect access to and quality of care.

Very readable. Recommended for anyone who enjoyed "Being Mortal" by Atul Gawande....more

Truly inspiring book for someone pursuing the medical field. Through Pearson's personal stories from her time in medical school and time spent volunteering at a student-run free clinic in Galveston, TX, she reveals the brokenness of the American health system, the trials of working with the uninsured, and the compassion and sacrifices it takes to be a good doctor.

For anyone working in a healthcare position, NAD does a fantastic job in detailing the life of a medical professional and a journey that includes human error and lessons while working with others. The writing is honest and really makes you reflect and think on your own work with patients.